Provider Demographics
NPI:1841001476
Name:STRIDE, TRACY (LPCC)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:STRIDE
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5197 KNOTTY PINE LN
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-7525
Mailing Address - Country:US
Mailing Address - Phone:303-907-5845
Mailing Address - Fax:
Practice Address - Street 1:3092 EVERGREEN PKWY STE 100
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-7849
Practice Address - Country:US
Practice Address - Phone:303-907-5845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0022881101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health